Individual
TANYA MAMMENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1714 ABBEY RD, PIERRE, SD 57501-7805
(605) 224-8841
(605) 224-6852
Mailing address
1714 ABBEY RD, PIERRE, SD 57501-7805
(605) 224-8841
(605) 224-6852
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13011557
SD
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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